Journal Article

The effects of single and a combination of determinants of anaemia in the very old: results from the TULIPS consortium

Gussekloo, Jacobijn, den Elzen, Wendy P. J., Blom, Jeanet W., Martin-Ruiz, Carmen, Duncan, Rachel, Jagger, Carol, Palapar, Leah, Wang, Pin-Chun, Arai, Yasumichi, Abe, Yukiko, Kerse, Ngaire

2021

Overview

Background and objectives Nutritional deficiencies, renal impairment and chronic inflammation are commonly mentioned determinants of anaemia. The aim of this study was to investigate the effects of these determinants, singly and in combination, on anaemia in the very old. Method The TULIPS Consortium consists of four population-based studies in oldest-old individuals: Leiden 85-plus Study, LiLACS NZ, Newcastle 85+ study, and TOOTH. Five selected determinants (iron, vitamin B12, and folate deficiency; low estimated glomerular filtration rate (eGFR); and high C-reactive protein (CRP)) were summed. This sum score was used to investigate the association with the presence and onset of anaemia (WHO definition). The individual study results were pooled using random-effects models. Results In the 2216 participants (59% female, 30% anaemia) at baseline, iron deficiency, low eGFR and high CRP were individually associated with the presence of anaemia. Low eGFR and high CRP were individually associated with the onset of anaemia. In the cross-sectional analyses, an increase per additional determinant (adjusted OR 2.10 (95% CI 1.85–2.38)) and a combination of ≥2 determinants (OR 3.44 (95% CI 2.70–4.38)) were associated with the presence of anaemia. In the prospective analyses, an increase per additional determinant (adjusted HR 1.46 (95% CI 1.24–1.71)) and the presence of ≥2 determinants (HR 1.95 (95% CI 1.40–2.71)) were associated with the onset of anaemia. Conclusion Very old adults with a combination of determinants of anaemia have a higher risk of having, and of developing, anaemia. Further research is recommended to explore causality and clinical relevance.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age / Aged, 80 and over / Aging / Anemia / Anemia - diagnosis / Anemia - epidemiology / Blood / C-reactive protein / Cardiovascular disease / Caregivers / Collaboration / Consortia / Cross-Sectional Studies / Demographic aspects / Diagnosis / Epidermal growth factor receptors / Ethics / Fasting / Folic acid / Folic Acid Deficiency / Geriatrics / Geriatrics/Gerontology / Glomerular filtration rate / Hemoglobin / Humans / Inflammation / Informed consent / Institutionalization / Iron / Iron deficiency / Laboratories / Low haemoglobin levels / Medicine / Medicine & Public Health / Mortality / Nutrient deficiency / nutrition and epidemiology / Older people / Population studies / Population-based studies / Prospective Studies / Public health / Questionnaires / Rehabilitation / Renal impairment / Research Article / Risk factors / Sociodemographics / Tulipa / Vitamin B / Vitamin B12 / Vitamin B12/folate deficiency / Vitamin deficiency